Individual
DE ANDRE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9808 VENICE BLVD STE 505, CULVER CITY, CA 90232-6818
(310) 237-0461
(310) 945-3356
Mailing address
9808 VENICE BLVD STE 505, CULVER CITY, CA 90232-6818
(310) 237-0461
(310) 945-3356
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
09/29/2017
Last updated
07/21/2022
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